Fewer than 10 percent of people with HIV who should take aspirin to prevent a heart attack actually take the medication, according to a small study published in the August 15 issue of the Journal of Acquired Immune Deficiency Syndromes.

A number of studies have found that a small dose, usually 81 milligrams per day, offers at least some protection from a heart attack, especially in those who have already had one heart attack or who have risk factors for cardiovascular disease, such as diabetes. Moreover, though aspirin can cause gastrointestinal bleeding, the United States Preventive Services Task Force (USPSTF) currently recommends that men ages 45 to 79 and women 55 to 79 should take low-dose aspirin to prevent a heart attack—because the task force concluded that the risk of a heart attack in these age groups outweighed the potential side effects.

People with HIV are at just as much of a risk for a heart attack as the general population. In fact, a number of recent studies have found that people with HIV are at a significantly higher risk of heart attacks and other cardiovascular disease (CVD)-related health problems than HIV-negative with similar risk factors. Thus, Carlos Tornero, MD, and his colleagues from the Department of Internal Medicine at the Hospital Gandia in Gandia, Spain, wondered whether people with HIV were receiving aspirin as recommended by USPSTF guidelines.

Tornero’s group examined the medical records of 120 HIV-positive patients at their hospital and included all information related to CVD risk. They found that based on CVD risk and the USPSTF guidelines, 31 percent of the patients should be receiving low-dose aspirin, yet only 2 percent were. Among men, 40 percent should have been receiving aspirin. Further, without modifying existing risk factors, Tornero and his colleagues estimated that an additional 15 percent would require aspirin over the next five years.

“Application of the recently published recommendations on the use of aspirin in HIV-infected patients could help reduce the risk in cardiovascular events described in some studies,” the authors asserted. “Aspirin would be indicated in a large proportion of patients, particularly in males.”

“In the management of [CVD risk] among HIV-infected patients, it is therefore necessary to also consider aspirin as a primary prevention treatment,” they concluded.